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16.05.2019 | Review Article Open Access

Danish national clinical guidelines for surgical and nonsurgical treatment of patients with lumbar spinal stenosis

Zeitschrift:
European Spine Journal
Autoren:
Rikke Rousing, Rikke Krüger Jensen, Søren Fruensgaard, Janni Strøm, Helle Algren Brøgger, Jørgen Dan Møller Degn, Mikkel Ø. Andersen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00586-019-05987-2) contains supplementary material, which is available to authorized users.

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Abstract

Purpose

To summarize the recommendations from the national clinical guideline published by the Danish Health Authority regarding surgical and nonsurgical interventions in treatment of lumbar spinal stenosis in patients above the age of 65 years.

Methods

A multidisciplinary working group formulated recommendations based on the GRADE approach.

Results

Seven of the recommendations were based on randomized controlled trials and three on professional consensus. The guideline recommends surgical decompression for symptomatic lumbar spinal stenosis. Supervised exercise and postsurgical supervised exercise are recommended due to the general beneficial effects of training on general health, even though there was no evidence on an effect on neurogenic pain. The guideline does not recommend manual therapy, paracetamol, NSAIDs, opioids, neurogenic pain medication, muscle relaxants, and decompression combined with instrumented fusion as there was no evidence of the beneficial effect.

Conclusion

The recommendations are based on low to very low quality of evidence or professional consensus as well as patient preferences and positive or harmful effects of the intervention. The true treatment effect may therefore be different from the estimated effects, which is why the results should be interpreted with caution. The working group recommends intensified research in relation to all aspects of management of lumbar spinal stenosis.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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Zusatzmaterial
Supplementary material 1 (PPTX 139 kb)
586_2019_5987_MOESM1_ESM.pptx
Literatur
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